Provider Demographics
NPI:1124745815
Name:COUNTY OF RIVERSIDE
Entity type:Organization
Organization Name:COUNTY OF RIVERSIDE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PUBLIC HEALTH OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:GEOFFREY
Authorized Official - Middle Name:WON-CHEN
Authorized Official - Last Name:LEUNG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:951-358-5121
Mailing Address - Street 1:4065 COUNTY CIRCLE DRIVE
Mailing Address - Street 2:SUITE 302
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92503
Mailing Address - Country:US
Mailing Address - Phone:951-358-5120
Mailing Address - Fax:
Practice Address - Street 1:4065 COUNTY CIRCLE DRIVE
Practice Address - Street 2:SUITE 302
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92503
Practice Address - Country:US
Practice Address - Phone:951-358-5120
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-24
Last Update Date:2022-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251K00000XAgenciesPublic Health or Welfare
No171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty